Development of a therapeutic device for esophageal stricture lesions and verification of the efficacy of local heating

Abstract

Benign esophageal stricture is a condition that narrows the esophageal lumen and causes dysphagia, often following esophageal cancer treatment. The lesion accumulates collagen due to excessive healing of tissue damage called fibrosis. Collagen serves to harden the strength of the tissue, thus making the lesion mechanically stiff. The standard treatment for benign esophageal stricture is balloon dilatation, which mechanically widens the esophagus, leading to repeated lacerations and restenosis during recovery. We proposed a treatment concept in which balloon dilatation is followed by local heating of the lesion to reduce lacerations and subsequent restenosis. We believe that heating decreases lacerations by thermally denaturing collagen to gelatin and decreasing tissue strength. We developed a balloon that can be simultaneously heated and dilated by hot water flowing through its interior. We performed porcine animal experiments with a locally heated balloon in which the heated area was restricted by an insulating membrane. We successfully heated and dilated a locally heated balloon and evaluated the effect of heating on the tissue by staining the lesion with HE and MT. The results provide insight into tissue damage caused by esophageal cancer treatment and tissue damage caused by heating.